Refugee Claimants - Intake Form Your Personal DetailsPrénom(Nécessaire)Middle NameNom de famillePreferred/Other NameDate de naissance(Nécessaire) JJ barre oblique MM barre oblique AAAA Marital Status(Nécessaire)Common-LawDivorcedMarriedSeparatedSingleWidowedUnknownGenre(Nécessaire)FemelleMâleUnknownNon-BinaryEmail Address(Nécessaire) Phone Number(Nécessaire)Téléphone secondairePrevious Profession00010 - Legislators00011 - Senior government managers and officials00012 - Senior managers - financial, communications and other business servicesCadres supérieurs – santé, éducation, services sociaux et communautaires et organismes associatifs – 0001300014 - Senior managers - trade, broadcasting and other services00015 - Senior managers - construction, transportation, production and utilities10010 - Financial managers10011 - Human resources managers10012 - Purchasing managers10019 - Other administrative services managers10020 - Insurance, real estate and financial brokerage managers10021 - Banking, credit and other investment managers10022 - Advertising, marketing and public relations managers10029 - Other business services managers10030 - Telecommunication carriers managers70021 - Postal and courier services managers20010 - Engineering managers20011 - Architecture and science managers20012 - Computer and information systems managers30010 - Managers in health care40010 - Government managers - health and social policy development and program administration40011 - Government managers - economic analysis, policy development and program administration40012 - Government managers - education policy development and program administration40019 - Other managers in public administration40020 - Administrators - post-secondary education and vocational training40021 - School principals and administrators of elementary and secondary education40030 - Managers in social, community and correctional services40040 - Commissioned police officers and related occupations in public protection services40041 - Fire chiefs and senior firefighting officers40042 - Commissioned officers of the Canadian Armed Forces50010 - Library, archive, museum and art gallery managers50011 - Managers - publishing, motion pictures, broadcasting and performing arts50012 - Recreation, sports and fitness program and service directors60010 - Corporate sales managers60020 - Retail and wholesale trade managers60030 - Restaurant and food service managers60031 - Accommodation service managers60040 - Managers in customer and personal services70010 - Construction managers70011 - Home building and renovation managers70012 - Facility operation and maintenance managers70020 - Managers in transportation80010 - Managers in natural resources production and fishing80020 - Managers in agriculture80021 - Managers in horticulture80022 - Managers in aquaculture90010 - Manufacturing managers90011 - Utilities managers11100 - Financial auditors and accountants11101 - Financial and investment analysts11103 - Securities agents, investment dealers and brokers11102 - Financial advisors11109 - Other financial officers11200 - Human resources professionals11201 - Professional occupations in business management consulting11202 - Professional occupations in advertising, marketing and public relations12010 - Supervisors, general office and administrative support workers12011 - Supervisors, finance and insurance office workers12012 - Supervisors, library, correspondence and related information workers72025 - Supervisors, mail and message distribution occupations12013 - Supervisors, supply chain, tracking and scheduling coordination occupations13100 - Administrative officers12100 - Executive assistants12101 - Human resources and recruitment officers13101 - Property administrators12102 - Procurement and purchasing agents and officers12103 - Conference and event planners43203 - Border services, customs, and immigration officers12104 - Employment insurance and revenue officers13110 - Administrative assistants13111 - Legal administrative assistants13112 - Medical administrative assistants12110 - Court reporters, medical transcriptionists and related occupations12111 - Health information management occupations12112 - Records management technicians12113 - Statistical officers and related research support occupations12200 - Accounting technicians and bookkeepers12201 - Insurance adjusters and claims examiners12202 - Insurance underwriters12203 - Assessors, business valuators and appraisers13200 - Customs, ship and other brokers14100 - General office support workers14101 - Receptionists14102 - Personnel clerks14103 - Court clerks and related court services occupations14111 - Data entry clerks14112 - Desktop publishing operators and related occupations14200 - Accounting and related clerks13102 - Payroll administrators14201 - Banking, insurance and other financial clerks14202 - Collection clerks14300 - Library assistants and clerks14301 - Correspondence, publication and regulatory clerks14110 - Survey interviewers and statistical clerks64401 - Postal services representatives74100 - Mail and parcel sorters and related occupations74101 - Letter carriers75201 - Delivery service drivers and door-to-door distributors14400 - Shippers and receivers14401 - Storekeepers and partspersons14402 - Production logistics workers13201 - Production and transportation logistics coordinators14403 - Purchasing and inventory control workers14404 - Dispatchers14405 - Transportation route and crew schedulers21100 - Physicists and astronomers21101 - Chemists21102 - Geoscientists and oceanographers21103 - Meteorologists and climatologists21109 - Other professional occupations in physical sciences21110 - Biologists and related scientists21111 - Forestry professionals21112 - Agricultural representatives, consultants and specialists21300 - Civil engineers21301 - Mechanical engineers21310 - Electrical and electronics engineers21320 - Chemical engineers21321 - Industrial and manufacturing engineers21322 - Metallurgical and materials engineers21330 - Mining engineers21331 - Geological engineers21332 - Petroleum engineers21390 - Aerospace engineers21311 - Computer engineers (except software engineers and designers)21399 - Other professional engineers21200 - Architects21201 - Landscape architects21202 - Urban and land use planners21203 - Land surveyors21210 - Mathematicians, statisticians and actuaries21222 - Information systems specialists21220 - Cybersecurity specialists21221 - Business systems specialists21211 - Data scientists21223 - Database analysts and data administrators21231 - Software engineers and designers21230 - Computer systems developers and programmers21232 - Software developers and programmers21234 - Web developers and programmers21233 - Web designers22100 - Chemical technologists and technicians22101 - Geological and mineral technologists and technicians22110 - Biological technologists and technicians22111 - Agricultural and fish products inspectors22112 - Forestry technologists and technicians22113 - Conservation and fishery officers22114 - Landscape and horticulture technicians and specialists22300 - Civil engineering technologists and technicians22301 - Mechanical engineering technologists and technicians22302 - Industrial engineering and manufacturing technologists and technicians22303 - Construction estimators22310 - Electrical and electronics engineering technologists and technicians22311 - Electronic service technicians (household and business equipment)22312 - Industrial instrument technicians and mechanics22313 - Aircraft instrument, electrical and avionics mechanics, technicians and inspectors22210 - Architectural technologists and technicians22211 - Industrial designers22212 - Drafting technologists and technicians22213 - Land survey technologists and technicians22214 - Technical occupations in geomatics and meteorology22230 - Non-destructive testers and inspectors22231 - Engineering inspectors and regulatory officers21120 - Public and environmental health and safety professionals22232 - Occupational health and safety specialists22233 - Construction inspectors72600 - Air pilots, flight engineers and flying instructors72601 - Air traffic controllers and related occupations72602 - Deck officers, water transport72603 - Engineer officers, water transport72604 - Railway traffic controllers and marine traffic regulators22220 - Computer network and web technicians22221 - User support technicians22222 - Information systems testing technicians31300 - Nursing coordinators and supervisors31301 - Registered nurses and registered psychiatric nurses31101 - Specialists in surgery31100 - Specialists in clinical and laboratory medicine31102 - General practitioners and family physicians31110 - Dentists31103 - Veterinarians31111 - Optometrists31201 - Chiropractors31302 - Nurse practitioners31209 - Other professional occupations in health diagnosing and treating31120 - Pharmacists31121 - Dietitians and nutritionists31112 - Audiologists and speech-language pathologists31202 - Physiotherapists31203 - Occupational therapists31204 - Kinesiologists and other professional occupations in therapy and assessment32120 - Medical laboratory technologists31303 - Physician assistants, midwives and allied health professionals33101 - Medical laboratory assistants and related technical occupations32104 - Animal health technologists and veterinary technicians32103 - Respiratory therapists, clinical perfusionists and cardiopulmonary technologists32121 - Medical radiation technologists32122 - Medical sonographers32123 - Cardiology technologists and electrophysiological diagnostic technologists33103 - Pharmacy technical assistants and pharmacy assistants32124 - Pharmacy technicians32129 - Other medical technologists and technicians32110 - Denturists32111 - Dental hygienists and dental therapists32112 - Dental technologists and technicians32100 - Opticians32200 - Traditional Chinese medicine practitioners and acupuncturists32209 - Other practitioners of natural healing32101 - Licensed practical nurses32102 - Paramedical occupations32201 - Massage therapists32109 - Other technical occupations in therapy and assessment33100 - Dental assistants and dental laboratory assistants33102 - Nurse aides, orderlies and patient service associates33109 - Other assisting occupations in support of health services41200 - University professors and lecturers41201 - Post-secondary teaching and research assistants41210 - College and other vocational instructors41220 - Secondary school teachers41221 - Elementary school and kindergarten teachers41320 - Educational counsellors41100 - Judges41101 - Lawyers and Quebec notaries31200 - Psychologists41300 - Social workers41301 - Therapists in counselling and related specialized therapies41302 - Religious leaders41311 - Probation and parole officers41321 - Career development practitioners and career counsellors (except education)41400 - Natural and applied science policy researchers, consultants and program officers41401 - Economists and economic policy researchers and analysts41402 - Business development officers and market researchers and analysts41403 - Social policy researchers, consultants and program officers41404 - Health policy researchers, consultants and program officers41405 - Education policy researchers, consultants and program officers41406 - Recreation, sports and fitness policy researchers, consultants and program officers41407 - Program officers unique to government41409 - Other professional occupations in social science42200 - Paralegals and related occupations42201 - Social and community service workers42202 - Early childhood educators and assistants42203 - Instructors of persons with disabilities43109 - Other instructors42204 - Religion workers42100 - Police officers (except commissioned)42101 - Firefighters41310 - Police investigators and other investigative occupations42102 - Specialized members of the Canadian Armed Forces43204 - Operations members of the Canadian Armed Forces44200 - Primary combat members of the Canadian Armed Forces44100 - Home child care providers44101 - Home support workers, caregivers and related occupations43100 - Elementary and secondary school teacher assistants43200 - Sheriffs and bailiffs43201 - Correctional service officers43202 - By-law enforcement and other regulatory officers51100 - Librarians51101 - Conservators and curators51102 - Archivists51111 - Authors and writers (except technical)51112 - Technical writers51110 - Editors51113 - Journalists51114 - Translators, terminologists and interpreters51120 - Producers, directors, choreographers and related occupations51121 - Conductors, composers and arrangers51122 - Musicians and singers53120 - Dancers53121 - Actors, comedians and circus performers53122 - Painters, sculptors and other visual artists52100 - Library and public archive technicians53100 - Registrars, restorers, interpreters and other occupations related to museum and art galleries53110 - Photographers52110 - Film and video camera operators52111 - Graphic arts technicians52112 - Broadcast technicians52113 - Audio and video recording techniciansAutres personnels techniques et de coordination du cinéma, de la radiodiffusion et des arts de la scène – 5211953111 - Motion pictures, broadcasting, photography and performing arts assistants and operators52114 - Announcers and other broadcasters55109 - Other performers52120 - Graphic designers and illustrators52121 - Interior designers and interior decorators53123 - Theatre, fashion, exhibit and other creative designers53124 - Artisans and craftspersons53125 - Patternmakers - textile, leather and fur products53200 - Athletes53201 - Coaches53202 - Sports officials and referees54100 - Program leaders and instructors in recreation, sport and fitness62010 - Retail sales supervisors62100 - Technical sales specialists - wholesale trade62101 - Retail and wholesale buyers63100 - Insurance agents and brokers63101 - Real estate agents and salespersons63102 - Financial sales representatives62020 - Food service supervisors62021 - Executive housekeepers62022 - Accommodation, travel, tourism and related services supervisors62023 - Customer and information services supervisors62024 - Cleaning supervisors62029 - Other services supervisors62200 - Chefs63200 - Cooks63201 - Butchers - retail and wholesale65202 - Meat cutters and fishmongers - retail and wholesale63202 - Bakers63210 - Hairstylists and barbers64200 - Tailors, dressmakers, furriers and milliners63220 - Shoe repairers and shoemakers62202 - Jewellers, jewellery and watch repairers and related occupations63221 - Upholsterers62201 - Funeral directors and embalmers64101 - Sales and account representatives - wholesale trade (non-technical)64100 - Retail salespersons and visual merchandisers64300 - Maîtres d'hôtel and hosts/hostesses64301 - Bartenders65200 - Food and beverage servers64310 - Travel counsellors64311 - Pursers and flight attendants64312 - Airline ticket and service agents64313 - Ground and water transport ticket agents, cargo service representatives and related clerks64314 - Hotel front desk clerks64320 - Tour and travel guides64322 - Outdoor sport and recreational guides64321 - Casino occupations64410 - Security guards and related security service occupations45100 - Student monitors, crossing guards and related occupations64400 - Customer services representatives - financial institutions64409 - Other customer and information services representatives64201 - Image, social and other personal consultants63211 - Estheticians, electrologists and related occupations65220 - Pet groomers and animal care workers65229 - Other support occupations in personal services65100 - Cashiers65101 - Service station attendants65102 - Store shelf stockers, clerks and order fillers65109 - Other sales related occupations65201 - Food counter attendants, kitchen helpers and related support occupations65210 - Support occupations in accommodation, travel and facilities set-up services65211 - Operators and attendants in amusement, recreation and sport65310 - Light duty cleaners65311 - Specialized cleaners65312 - Janitors, caretakers and heavy-duty cleaners73201 - General building maintenance workers and building superintendents65320 - Dry cleaning, laundry and related occupations65329 - Other service support occupationsEntrepreneurs et contremaîtres des métiers de l'usinage, du formage, du façonnage et du montage des métaux et personnel connexe – 7201072011 - Contractors and supervisors, electrical trades and telecommunications occupations72012 - Contractors and supervisors, pipefitting trades72013 - Contractors and supervisors, carpentry trades72014 - Contractors and supervisors, other construction trades, installers, repairers and servicers72100 - Machinists and machining and tooling inspectors72101 - Tool and die makers72102 - Sheet metal workers72103 - Boilermakers72104 - Structural metal and platework fabricators and fitters72105 - Ironworkers72106 - Welders and related machine operators72200 - Electricians (except industrial and power system)72201 - Industrial electricians72202 - Power system electricians72203 - Electrical power line and cable workers72205 - Telecommunications equipment installation and cable television service technicians72204 - Telecommunications line and cable installers and repairers72300 - Plumbers72301 - Steamfitters, pipefitters and sprinkler system installers72302 - Gas fitters72310 - Carpenters72311 - Cabinetmakers72320 - Bricklayers73100 - Concrete finishers73101 - Tilesetters73102 - Plasterers, drywall installers and finishers and lathers73110 - Roofers and shinglers73111 - Glaziers72321 - Insulators73112 - Painters and decorators (except interior decorators)73113 - Floor covering installers72020 - Contractors and supervisors, mechanic trades72021 - Contractors and supervisors, heavy equipment operator crews72022 - Supervisors, printing and related occupations72023 - Supervisors, railway transport operations72024 - Supervisors, motor transport and other ground transit operators72400 - Construction millwrights and industrial mechanics72401 - Heavy-duty equipment mechanics72402 - Heating, refrigeration and air conditioning mechanics72403 - Railway carmen/women72404 - Aircraft mechanics and aircraft inspectors72405 - Machine fitters72406 - Elevator constructors and mechanics72410 - Automotive service technicians, truck and bus mechanics and mechanical repairers72411 - Auto body collision, refinishing and glass technicians and damage repair estimators72420 - Oil and solid fuel heating mechanics72421 - Appliance servicers and repairers72422 - Electrical mechanics72423 - Motorcycle, all-terrain vehicle and other related mechanics72429 - Other small engine and small equipment repairers73310 - Railway and yard locomotive engineers73311 - Railway conductors and brakemen/women72500 - Crane operators73402 - Drillers and blasters - surface mining, quarrying and construction72501 - Water well drillers73401 - Printing press operators72999 - Other technical trades and related occupations73200 - Residential and commercial installers and servicers74204 - Utility maintenance workers73202 - Pest controllers and fumigators73209 - Other repairers and servicers75100 - Longshore workers75101 - Material handlers73300 - Transport truck drivers73301 - Bus drivers, subway operators and other transit operators75200 - Taxi and limousine drivers and chauffeurs74102 - Couriers and messengers73400 - Heavy equipment operators74205 - Public works maintenance equipment operators and related workers74200 - Railway yard and track maintenance workers74201 - Water transport deck and engine room crew75210 - Boat and cable ferry operators and related occupations74202 - Air transport ramp attendants74203 - Automotive and heavy truck and equipment parts installers and servicers75110 - Construction trades helpers and labourers75119 - Other trades helpers and labourers75212 - Public works and maintenance labourers75211 - Railway and motor transport labourers82010 - Supervisors, logging and forestry82020 - Supervisors, mining and quarrying82021 - Contractors and supervisors, oil and gas drilling and services83100 - Underground production and development miners83101 - Oil and gas well drillers, servicers, testers and related workers83110 - Logging machinery operators82030 - Agricultural service contractors and farm supervisors85100 - Livestock labourers82031 - Contractors and supervisors, landscaping, grounds maintenance and horticulture services83120 - Fishing masters and officers83121 - Fishermen/women84100 - Underground mine service and support workers84101 - Oil and gas well drilling and related workers and services operators84110 - Chain saw and skidder operators84111 - Silviculture and forestry workers84120 - Specialized livestock workers and farm machinery operators85103 - Nursery and greenhouse labourers84121 - Fishing vessel deckhands85104 - Trappers and hunters85101 - Harvesting labourers85121 - Landscaping and grounds maintenance labourers85102 - Aquaculture and marine harvest labourers85110 - Mine labourers85111 - Oil and gas drilling, servicing and related labourers85120 - Logging and forestry labourers92010 - Supervisors, mineral and metal processing92011 - Supervisors, petroleum, gas and chemical processing and utilities92012 - Supervisors, food and beverage processing92013 - Supervisors, plastic and rubber products manufacturing92014 - Supervisors, forest products processing92015 - Supervisors, textile, fabric, fur and leather products processing and manufacturing92020 - Supervisors, motor vehicle assembling92021 - Supervisors, electronics and electrical products manufacturing92022 - Supervisors, furniture and fixtures manufacturing92023 - Supervisors, other mechanical and metal products manufacturing92024 - Supervisors, other products manufacturing and assembly93100 - Central control and process operators, mineral and metal processing93101 - Central control and process operators, petroleum, gas and chemical processing93102 - Pulping, papermaking and coating control operators92100 - Power engineers and power systems operators92101 - Water and waste treatment plant operators94100 - Machine operators, mineral and metal processing94101 - Foundry workers94102 - Glass forming and finishing machine operators and glass cutters94103 - Concrete, clay and stone forming operators94104 - Inspectors and testers, mineral and metal processing94105 - Metalworking and forging machine operators94106 - Machining tool operators94107 - Machine operators of other metal products94110 - Chemical plant machine operators94111 - Plastics processing machine operators94112 - Rubber processing machine operators and related workers94120 - Sawmill machine operators94121 - Pulp mill, papermaking and finishing machine operators94129 - Other wood processing machine operators94122 - Paper converting machine operators94123 - Lumber graders and other wood processing inspectors and graders94124 - Woodworking machine operators94130 - Textile fibre and yarn, hide and pelt processing machine operators and workers94131 - Weavers, knitters and other fabric making occupations94132 - Industrial sewing machine operators94133 - Inspectors and graders, textile, fabric, fur and leather products manufacturing94140 - Process control and machine operators, food and beverage processing94141 - Industrial butchers and meat cutters, poultry preparers and related workers94142 - Fish and seafood plant workers94143 - Testers and graders, food and beverage processing94150 - Plateless printing equipment operators94151 - Camera, platemaking and other prepress occupations94152 - Binding and finishing machine operators94153 - Photographic and film processors93200 - Aircraft assemblers and aircraft assembly inspectors94200 - Motor vehicle assemblers, inspectors and testers94201 - Electronics assemblers, fabricators, inspectors and testers94202 - Assemblers and inspectors, electrical appliance, apparatus and equipment manufacturing94203 - Assemblers, fabricators and inspectors, industrial electrical motors and transformers94204 - Mechanical assemblers and inspectors94205 - Machine operators and inspectors, electrical apparatus manufacturing94210 - Furniture and fixture assemblers, finishers, refinishers and inspectors94211 - Assemblers and inspectors of other wood products94212 - Plastic products assemblers, finishers and inspectors94213 - Industrial painters, coaters and metal finishing process operators94219 - Other products assemblers, finishers and inspectors95100 - Labourers in mineral and metal processing95101 - Labourers in metal fabrication95102 - Labourers in chemical products processing and utilities95103 - Labourers in wood, pulp and paper processing95104 - Labourers in rubber and plastic products manufacturing95105 - Labourers in textile processing and cutting95106 - Labourers in food and beverage processing95107 - Labourers in fish and seafood processing95109 - Other labourers in processing, manufacturing and utilitiesPreferred Service in(Nécessaire)EnglishFrenchNative Language(Nécessaire)EnglishFrenchAfrikaansAlbanianAmharicArabicArmenianBengaliBisayaBurmeseCantoneseCatalanCebuanoChineseChinese - SimplifiedChinese - TraditionalCreoleCroatianCzechDanishDutchFarsi (Persian)FilipinoGermanGujaratiHiligaynonHindiHungarianIlicanIlocanoIndonesianItalianItsekiriJapaneseKarenKinyarwandaKoreanMalagasyMalayalamMandarinMarathiMizoNepaliOther Middle Eastern LanguagesPashtoPolishPortuguesePunjabiRomanianRussianSerbianShonaSinhaleseSloveneSomaliSpanishSwahiliTagalogTamilTeluguThaiTigrignaTurkishUkrainianUrduVietnameseYorubaAcholiAdaAffarAfghanAkaAkanAklanonAkraAmerican Sign Language (ASL)Anuak (Anywa)AranAshantiAssameseAssyrianAzeriBahasa IndonesianBalochiBambaraBamileke / GhomalaBansoBantuBauleBelarusianBelenBembaBembeBeniBeninBerberBetiBhariBicol/Bikol/BicolanoBijaiyaBilenBiniBissaBontokBraille (translation only)BretonBulgarianBurji / Bembala / Bambala / DaashiBusanBusangoChakmaChaldeanChaochoChavacanoChichewaChinChiuchowChiyaoChowchauConcaniCreeDagaareDariDaza / Dazaga / TebuDinkaDioulaDzongkhaEdoEfikEsanEstonianEweFangFantiFe'fe / Fe'efe'e / Nufi / BafangFinnishFlemishFoochowFoukiFoullahFukineseFulaniGaGaelicGeorgianGrebo/KrumenGreekGuerzeHainamHakha ChinHakkaHararaHararyHargarHassanyaHausaHebrewHindkoHokkinIbibioIboIcelandicIdomaIgboIgorotIjawIkaIlongoIshanIvbiosakonIziJaraiJavaneseJingpoJolayJuba ArabicKacchiKakwaKanareseKandahariKankaniKannadaKapampanganKashmiriKazakhKenyang / Nyang / Banyang / ManyangKhmerKifuliruKihavuKihemba/Hemba/Kiluba-HembaKikambaKikongoKinnauriKinyamulengeKiregaKirundiKiswahiliKitubaKonkaniKpelleKrioKurdishKurmanjiKyrgyzLa langue des signes québécoise (LSQ)LaotianLariLatvianLebaneseLengieLingalaLithuanianLowmaLugandaLugishuLutoroMabanMacedonianMacenaMacuaMahouMakondeMalayMaligoMalinkeMalteseMandeMandingoMasalitMashiMendeMinaMoldovanMongolianMooreNaandi/CemualNdebeleNgiemboonNgombaNorwegianNubianNuerNzimaOkoOkpeOriyaOromoOsalOther African LanguagesOther Chinese DialectsOther European LanguagesOther LanguagesOther Signed LanguagesOther South Asian LanguagesOther South East Asian Lang.OtuhoPahariPampangoPangasinanPeulPhuockienPidginPlautdietschPoularRohingyaRomaniRukigaRunyankoleRutooroSahoSamoanSangoSanskritSaraScoulaSechuanSenufoSerbo-CroatianSesothoSeswiSeychellesShanShanghaiShansaiShillukSign LanguageSindhiSlovakSonghaiSoninkeSoraniSothoSoussouSouthern BurunSuesueSukumaSwazaiSwedishSwiss GermanTaichewTamasheqTariTatarTatshaneseTemneTeochewTibetanTichiewTigreTiminiTivToishanTshilubaTsibulaTwiUdukUhroboUigrigmaUmbunduUnamaUnknownUyghurUzbekVisayanWarayWelshWestern Hemisphere Indian LangWolofXhosaYacoubaYako/Loko/LokaaYekhee/Afenmai/AfemaiYiboeYiddishZandeZshilubaZugandaZuluOther Spoken Languages (if applicable)EnglishFrenchAfrikaansAlbanianAmharicArabicArmenianBengaliBisayaBurmeseCantoneseCatalanCebuanoChineseChinese - SimplifiedChinese - TraditionalCreoleCroatianCzechDanishDutchFarsi (Persian)FilipinoGermanGujaratiHiligaynonHindiHungarianIlicanIlocanoIndonesianItalianItsekiriJapaneseKarenKinyarwandaKoreanMalagasyMalayalamMandarinMarathiMizoNepaliOther Middle Eastern LanguagesPashtoPolishPortuguesePunjabiRomanianRussianSerbianShonaSinhaleseSloveneSomaliSpanishSwahiliTagalogTamilTeluguThaiTigrignaTurkishUkrainianUrduVietnameseYorubaAcholiAdaAffarAfghanAkaAkanAklanonAkraAmerican Sign Language (ASL)Anuak (Anywa)AranAshantiAssameseAssyrianAzeriBahasa IndonesianBalochiBambaraBamileke / GhomalaBansoBantuBauleBelarusianBelenBembaBembeBeniBeninBerberBetiBhariBicol/Bikol/BicolanoBijaiyaBilenBiniBissaBontokBraille (translation only)BretonBulgarianBurji / Bembala / Bambala / DaashiBusanBusangoChakmaChaldeanChaochoChavacanoChichewaChinChiuchowChiyaoChowchauConcaniCreeDagaareDariDaza / Dazaga / TebuDinkaDioulaDzongkhaEdoEfikEsanEstonianEweFangFantiFe'fe / Fe'efe'e / Nufi / BafangFinnishFlemishFoochowFoukiFoullahFukineseFulaniGaGaelicGeorgianGrebo/KrumenGreekGuerzeHainamHakha ChinHakkaHararaHararyHargarHassanyaHausaHebrewHindkoHokkinIbibioIboIcelandicIdomaIgboIgorotIjawIkaIlongoIshanIvbiosakonIziJaraiJavaneseJingpoJolayJuba ArabicKacchiKakwaKanareseKandahariKankaniKannadaKapampanganKashmiriKazakhKenyang / Nyang / Banyang / ManyangKhmerKifuliruKihavuKihemba/Hemba/Kiluba-HembaKikambaKikongoKinnauriKinyamulengeKiregaKirundiKiswahiliKitubaKonkaniKpelleKrioKurdishKurmanjiKyrgyzLa langue des signes québécoise (LSQ)LaotianLariLatvianLebaneseLengieLingalaLithuanianLowmaLugandaLugishuLutoroMabanMacedonianMacenaMacuaMahouMakondeMalayMaligoMalinkeMalteseMandeMandingoMasalitMashiMendeMinaMoldovanMongolianMooreNaandi/CemualNdebeleNgiemboonNgombaNorwegianNubianNuerNzimaOkoOkpeOriyaOromoOsalOther African LanguagesOther Chinese DialectsOther European LanguagesOther LanguagesOther Signed LanguagesOther South Asian LanguagesOther South East Asian Lang.OtuhoPahariPampangoPangasinanPeulPhuockienPidginPlautdietschPoularRohingyaRomaniRukigaRunyankoleRutooroSahoSamoanSangoSanskritSaraScoulaSechuanSenufoSerbo-CroatianSesothoSeswiSeychellesShanShanghaiShansaiShillukSign LanguageSindhiSlovakSonghaiSoninkeSoraniSothoSoussouSouthern BurunSuesueSukumaSwazaiSwedishSwiss GermanTaichewTamasheqTariTatarTatshaneseTemneTeochewTibetanTichiewTigreTiminiTivToishanTshilubaTsibulaTwiUdukUhroboUigrigmaUmbunduUnamaUnknownUyghurUzbekVisayanWarayWelshWestern Hemisphere Indian LangWolofXhosaYacoubaYako/Loko/LokaaYekhee/Afenmai/AfemaiYiboeYiddishZandeZshilubaZugandaZuluNumber of Adults in your HouseholdNumber of Children in your HouseholdCurrent Residential AddressAdresse(Nécessaire)Apt/Unit #CityWinnipegAnolaArborgBeauséjourEriksdaleGimliHeadingleyIle des ChênesLa SalleLoretteBanque de chêneSelkirkSaint-AdolpheSaint-MaloSainte-AnneSteinbachStonewallTeulonPlage de WinnipegForêt provinciale d'AgassizAlexandreAlonsaAltonaArmstrongAshernAubignyAustinBaldurTilleulBelmontBenitoRivière BerensBeulahBinscarthBirnieBirtleBissetFleuristeBoissevainBrandonBrochetBrookdaleBrunkildCampervilleCarberryCarmanCartwrightChurchillRuisseau CooksCormoranCowanPortage aux cannebergesCrandallLac CrossLa Cité de CristalRivière CypressDarlingfordDauphinDéloraineVille de DominionDufresneDugaldBraintree EstVille de PâquesEddystoneEdenEdwinElginÉlieCorne d'élanRuisseau de l'OrmeElmaEmersonÉricksonEthelbertLac du FauconBranche de FisherRivière FisherFlin FlonRivière ForkFoxwarrenBois de FraserJardintonPlaines de GilbertGillamGirouxGladstoneGlenboroGlenellaLe détroit du lac des DieuxGrande PlageGrand RapidsVue grandioseGretnaGrunthalGypsumvilleHadashvilleHamiotaHartneyHazelridgeHéclaHodgsonHollandeIlfordInwoodLac de l'îleKelwoodKentonKillarneyKleefeldKolaKomarnoLa BroquerieLac BrochetLac du BonnetPoint de repèreLangruthRapides de la feuilleLibauTilleulPetits rapides de Grand RapidsPort-de-LockFerme LoweLundarLac LynnMacGregorFabricationManigotaganManitouMarchandMcAuleyMcCrearyMélitaMiamiMilieuMiniotaMinnedosaMintoLac MooseMordenMorrisNeepawaMaison NelsonNewdaleNivervilleMaison de NorvègeNotre Dame de LourdesLac du ChêneRivière du ChêneOakvilleRivière OcreOtterburneMaison d'OxfordPenséePéguisRapides du PélicanPikwitoneiMonticule pilotePinawaQuai de pinChutes de pinsRivière des PinsPinCoulée de prunesPlumesPointe du BoisRivière des peupliersChamp de peupliersPortage la PrairiePrawdaRandolphVille rapideRathwellLac Red SuckerRennieRestonPlus richeLes rivièresRivertonRoblinRolandRorketonRoseRivière RoseauRosenortPalissandreRossRossburnRusselLes SandilandsLac de SableSanfordSartoSchanzenfeldLes chutes des Sept SœursShamattawaShiloLac ShoalSidneySiftonLac de neigeFlocon de neigeSomersetSourisLac indien du sudJonction SudSperlingLac SplitSpragueSaint-Pierre-JolysSaint-ClaudeSaint François XavierSaint Jean BaptisteSaint-LaurentSaint-LazareStarbuckSainte-AgatheSainte-Rose-du-LacRocher escarpéStrathclairCoucherLe Lac des CygnesRivière des CygnesLac TadouleLe PasPortage du FourréThompsonTolstoïTourondTreherneTyndaleVassarVirdenVitaWaasagomachWabowdenSans WanWasagamingPoule d'eauWawanesaBouche blancheWinklerWinnipegoseForêtsBoismoreBoiséZhodaProvince(Nécessaire)ManitobaCode Postal(Nécessaire)Immigration Related InformationStatut au Canada(Nécessaire)RC - Refugee ClaimantPoint of Entry (Port, border point)(Nécessaire)AlbertaColombie britanniqueManitobaNouveau-BrunswickTerre-Neuve-et-LabradorTerritoires du nord-ouestNouvelle-ÉcosseNunavutOntarioÎle-du-Prince-ÉdouardQuébecSaskatchewanYukonDate of Arrival in Manitoba JJ barre oblique MM barre oblique AAAA Pays de naissanceAfghanistanAlbanieAurignyAlgérieSamoa américainesAndorreAngolaAnguillaAntigua-et-BarbudaArgentineArménieAustralieL'AutricheAzerbaïdjanBahamasBahreïnBangladeshBarbadeBiélorussieBelgiqueBélizeBeninBermudesBhoutanBolivieBosnie HerzégovineBotswanaBrésilÎles Vierges britanniquesBrunéiBulgarieBurkina FasoMyanmar (anciennement Birmanie)BurundiCamerounCanadales îles CanariesCap-VertÎles CaïmansRépublique centrafricaineTchadChiliChine (RPC)ColombieComoresRépublique démocratique du CongoCongo (République du Congo)Costa RicaCroatieCubaChypreTchéquie (République tchèque)DanemarkDjiboutiRépublique dominicaineÉquateurEgypteLe SalvadorAngleterreGuinée ÉquatorialeÉrythréeEstonieEthiopieAllemagneFidjiFinlandeLe P. PolynésieFranceGuyane FrançaiseGabonGambieGéorgieGhanaGrèceGroenlandGrenadeGuadeloupeGuamGuatemalaGuinéeGuinée-bissauGuyaneHaïtiHondurasHong KongHongrieIslandeIndeIndonésieL'IranIrakIrlandeIsraëlItalieCôte d'Ivoire (Côte d'Ivoire)JamaïqueJaponJordanKazakhstanKenyaÎles KerguelenKirghizistanKiribatiCorée du NordCOREE DU SUDKosovoKoweitLaosLettonieLibanLesothoLibériaLibyeLiechtensteinLituanieLuxembourgMacédoine du NordMadagascarMalawiMalaisieMaldivesMaliMalteIles MarshallMauritanieMauriceMexiqueMoldavieMonacoMongolieMontserratMarocMozambiqueNamibieNauruNépalPays-BasNouvelle CalédonieNouvelle-ZélandeNicaraguaNigerNigeriaIrlande du NordNorvègePakistanPalestinePanamaPapouasie Nouvelle GuinéeParaguayPérouPhilippinesÎles PitcairnPolognele PortugalPorto RicoQatarRéunionRoumanieRussieRwandaSamoaSaint MarinSao Tomé et PrincipeArabie SaouditeÉcosseSénégalSerbieSeychellesSierra LeoneSingapourLes îles SalomonSomalieAfrique du SudEspagneSri LankaSainte-HélèneSaint-Kitts-et-NevisSainte LucieSaint-Pierre-et-MiquelonSaint-Vincent-et-les GrenadinesApatrideSoudanSurinamEswatini (anciennement Swaziland)SuèdeSuisseSyrieTadjikistanTanzanieThaïlandeTibetAllerTongaTrinité-et-TobagoTunisieTurquieTurkménistanÎles Turques et CaïquesTuvaluÎles Vierges américainesles états-unis d'AmériqueOugandaUkraineEmirats Arabes UnisUruguayOuzbékistanVanuatuSaint-Siège (Cité du Vatican)VenezuelaViêt NamPays de GallesSahara occidentalYémenYougoslavieZambieZimbabweOmanSoudan, SudRoyaume-UniSlovénieSlovaquie (République slovaque)Taïwan (ROC)CambodgeDominiqueTimor oriental (Timor-Leste)MicronésieMonténégroPalaosPays d'origineAfghanistanAlbanieAurignyAlgérieSamoa américainesAndorreAngolaAnguillaAntigua-et-BarbudaArgentineArménieAustralieL'AutricheAzerbaïdjanBahamasBahreïnBangladeshBarbadeBiélorussieBelgiqueBélizeBeninBermudesBhoutanBolivieBosnie HerzégovineBotswanaBrésilÎles Vierges britanniquesBrunéiBulgarieBurkina FasoMyanmar (anciennement Birmanie)BurundiCamerounCanadales îles CanariesCap-VertÎles CaïmansRépublique centrafricaineTchadChiliChine (RPC)ColombieComoresRépublique démocratique du CongoCongo (République du Congo)Costa RicaCroatieCubaChypreTchéquie (République tchèque)DanemarkDjiboutiRépublique dominicaineÉquateurEgypteLe SalvadorAngleterreGuinée ÉquatorialeÉrythréeEstonieEthiopieAllemagneFidjiFinlandeLe P. PolynésieFranceGuyane FrançaiseGabonGambieGéorgieGhanaGrèceGroenlandGrenadeGuadeloupeGuamGuatemalaGuinéeGuinée-bissauGuyaneHaïtiHondurasHong KongHongrieIslandeIndeIndonésieL'IranIrakIrlandeIsraëlItalieCôte d'Ivoire (Côte d'Ivoire)JamaïqueJaponJordanKazakhstanKenyaÎles KerguelenKirghizistanKiribatiCorée du NordCOREE DU SUDKosovoKoweitLaosLettonieLibanLesothoLibériaLibyeLiechtensteinLituanieLuxembourgMacédoine du NordMadagascarMalawiMalaisieMaldivesMaliMalteIles MarshallMauritanieMauriceMexiqueMoldavieMonacoMongolieMontserratMarocMozambiqueNamibieNauruNépalPays-BasNouvelle CalédonieNouvelle-ZélandeNicaraguaNigerNigeriaIrlande du NordNorvègePakistanPalestinePanamaPapouasie Nouvelle GuinéeParaguayPérouPhilippinesÎles PitcairnPolognele PortugalPorto RicoQatarRéunionRoumanieRussieRwandaSamoaSaint MarinSao Tomé et PrincipeArabie SaouditeÉcosseSénégalSerbieSeychellesSierra LeoneSingapourLes îles SalomonSomalieAfrique du SudEspagneSri LankaSainte-HélèneSaint-Kitts-et-NevisSainte LucieSaint-Pierre-et-MiquelonSaint-Vincent-et-les GrenadinesApatrideSoudanSurinamEswatini (anciennement Swaziland)SuèdeSuisseSyrieTadjikistanTanzanieThaïlandeTibetAllerTongaTrinité-et-TobagoTunisieTurquieTurkménistanÎles Turques et CaïquesTuvaluÎles Vierges américainesles états-unis d'AmériqueOugandaUkraineEmirats Arabes UnisUruguayOuzbékistanVanuatuSaint-Siège (Cité du Vatican)VenezuelaViêt NamPays de GallesSahara occidentalYémenYougoslavieZambieZimbabweOmanSoudan, SudRoyaume-UniSlovénieSlovaquie (République slovaque)Taïwan (ROC)CambodgeDominiqueTimor oriental (Timor-Leste)MicronésieMonténégroPalaosCountry of Last ResidenceAfghanistanAlbanieAurignyAlgérieSamoa américainesAndorreAngolaAnguillaAntigua-et-BarbudaArgentineArménieAustralieL'AutricheAzerbaïdjanBahamasBahreïnBangladeshBarbadeBiélorussieBelgiqueBélizeBeninBermudesBhoutanBolivieBosnie HerzégovineBotswanaBrésilÎles Vierges britanniquesBrunéiBulgarieBurkina FasoMyanmar (anciennement Birmanie)BurundiCamerounCanadales îles CanariesCap-VertÎles CaïmansRépublique centrafricaineTchadChiliChine (RPC)ColombieComoresRépublique démocratique du CongoCongo (République du Congo)Costa RicaCroatieCubaChypreTchéquie (République tchèque)DanemarkDjiboutiRépublique dominicaineÉquateurEgypteLe SalvadorAngleterreGuinée ÉquatorialeÉrythréeEstonieEthiopieAllemagneFidjiFinlandeLe P. PolynésieFranceGuyane FrançaiseGabonGambieGéorgieGhanaGrèceGroenlandGrenadeGuadeloupeGuamGuatemalaGuinéeGuinée-bissauGuyaneHaïtiHondurasHong KongHongrieIslandeIndeIndonésieL'IranIrakIrlandeIsraëlItalieCôte d'Ivoire (Côte d'Ivoire)JamaïqueJaponJordanKazakhstanKenyaÎles KerguelenKirghizistanKiribatiCorée du NordCOREE DU SUDKosovoKoweitLaosLettonieLibanLesothoLibériaLibyeLiechtensteinLituanieLuxembourgMacédoine du NordMadagascarMalawiMalaisieMaldivesMaliMalteIles MarshallMauritanieMauriceMexiqueMoldavieMonacoMongolieMontserratMarocMozambiqueNamibieNauruNépalPays-BasNouvelle CalédonieNouvelle-ZélandeNicaraguaNigerNigeriaIrlande du NordNorvègePakistanPalestinePanamaPapouasie Nouvelle GuinéeParaguayPérouPhilippinesÎles PitcairnPolognele PortugalPorto RicoQatarRéunionRoumanieRussieRwandaSamoaSaint MarinSao Tomé et PrincipeArabie SaouditeÉcosseSénégalSerbieSeychellesSierra LeoneSingapourLes îles SalomonSomalieAfrique du SudEspagneSri LankaSainte-HélèneSaint-Kitts-et-NevisSainte LucieSaint-Pierre-et-MiquelonSaint-Vincent-et-les GrenadinesApatrideSoudanSurinamEswatini (anciennement Swaziland)SuèdeSuisseSyrieTadjikistanTanzanieThaïlandeTibetAllerTongaTrinité-et-TobagoTunisieTurquieTurkménistanÎles Turques et CaïquesTuvaluÎles Vierges américainesles états-unis d'AmériqueOugandaUkraineEmirats Arabes UnisUruguayOuzbékistanVanuatuSaint-Siège (Cité du Vatican)VenezuelaViêt NamPays de GallesSahara occidentalYémenYougoslavieZambieZimbabweOmanSoudan, SudRoyaume-UniSlovénieSlovaquie (République slovaque)Taïwan (ROC)CambodgeDominiqueTimor oriental (Timor-Leste)MicronésieMonténégroPalaosHave you submitted your claim?Yes, Inland after entry in CanadaYes, at the port of entryNo, haven't filed yetIf not, are you in need of a referral?OuiNonEmergency Contact InformationFull Name(Nécessaire)Phone Number(Nécessaire)E-mail(Nécessaire) Relationship(Nécessaire)Common Law SpousePartnerSpouseUnknownChildParentConsents and Confidentiality StatementMail Consent I consent to be added to the mailing list for information on events and workshops. 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